Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles. It is the most common cancer in men ages 20 to 35 years old. The rate of testicular cancer has doubled in American white men since the 1960s, though a reason has not been identified. Testicular cancer often can be cured with surgery, radiation and/or chemotherapy. If detected early, side effects of treatment are minimal.
Approximately 95 percent of testicular cancers are germ cell tumors (cancers that start in the cells that make sperm). There are two types of germ cell tumors:
- Nonseminomatous tumors include embryonal carcinoma, teratomas, yolk sac tumors and choriocarcinomas (rare but very aggressive) and account for about 60 percent of germ cell tumors. They grow and spread faster than seminomas. A tumor may contain both seminoma and nonseminoma cells.
- Seminoma tumors include classic, anaplastic or spermatocytic seminomas, which make up about 40 percent of germ cell tumors. They are usually slow growing and respond well to treatment.
Less than 5 percent of testicular cancers are stromal tumors, occurring in the supportive testicular tissue where hormones are produced.
The testicles (also called testes or gonads) are a pair of male sex glands located under the penis in a sac-like pouch called the scrotum. They produce and store sperm and are the main source of male hormones, which control the development of the reproductive organs and secondary (male) sexual characteristics.
Men with testicular cancer should discuss their concerns about sexual function and fertility with their doctor. It is important to know that men with testicular cancer often have fertility problems even before their cancer is treated. If a man has pre-existing fertility problems, or if he is to have treatment that might lead to infertility, he may want to ask the doctor about sperm banking (freezing sperm before treatment for use in the future). This procedure allows some men to have children even if the treatment causes loss of fertility.
Metastatic Testicular Cancer
When testicular cancer spreads beyond the testicle, it is considered metastatic disease. At this point, the cancer becomes more difficult to treat. The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary tumor and travel through the lymph or blood to other places in the body, a secondary tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if testicular cancer spreads to the lungs, the cancer cells in the lungs are actually testicular cancer cells. The disease is metastatic testicular cancer, not lung cancer.
As with most cancers, early detection is the best way to combat this disease, so being aware of the symptoms is important. These signs do not always mean cancer; other conditions may have similar signs. However, it’s important to seek immediate consultation if these symptoms are present. Symptoms of testicular cancer include:
- A painless lump or swelling in either testicle
- A change in how the testicle feels
- A dull ache in the lower abdomen, back or the groin
- A sudden build-up of fluid in the scrotum
- Pain or discomfort in a testicle or in the scrotum
- Weight loss